Treating Chemical and Biological Agent Casualties

Lesson 3: Treating Blood, Choking, and Blister Agent Casualties

3-4. TREAT A CHOKING (LUNG-DAMAGING) AGENT CASUALTY

If the casualty has suffered a lethal exposure, death usually occurs within 24 to 48 hours after exposure. Exposure to very high concentrations can result in death within 5 hours of exposure. After 48 to 72 hours, the pulmonary edema is gradually absorbed and the prognosis becomes better.

a. Mask the Casualty. If the casualty is able, have him to put on and clear his mask. Mask the casualty if the casualty cannot mask himself. Do not secure the hood at this time.

b. Keep Casualty Warm and at Rest (Symptomatic). Keep a casualty with signs and symptoms of choking agent poisoning (either early or late) comfortably warm and have him rest quietly. If the casualty is conscious and is able to sit up, keep him in a sitting position. If the casualty is unable to sit up, have him lie on his back. Do not administer sedatives unless adequate oxygenation is assured and facilities for respiratory assistance are available.

NOTE: A soldier who was briefly exposed to a choking agent but who does not have

signs and symptoms of choking agent poisoning may continue his combat

duties. If early signs and symptoms develop, treat with warmth and rest; then

evacuate the casualty.

c. Restrict Activities (Asymptomatic). A soldier in the asymptomatic phase (had signs and symptoms of early choking agent poisoning but now has no signs or symptoms of choking agent poisoning) can be assigned light duties that do not stress his respiratory system until he can be evacuated. Check the casualty periodically for the appearance of signs or symptoms of late choking agent poisoning.

d. Evacuate. Any soldier who has been exposed to a choking agent should be examined by a medical officer. Evacuate any casualty who has or has had signs and symptoms of choking agent poisoning to a medical treatment facility. If the casualty has difficulty in breathing, evacuate him by litter. If the casualty cannot lie flat on the litter (cannot breathe adequately lying down), evacuate him in a semi sitting position. Initiate a field medical card and attach the card to the casualty's clothing prior to evacuation.